15D2143485 CLIA NUMBER - PAYLESS PHARMACY #21-336

Laboratory Demographics

  • CLIA Code: 15D2143485
  • Facility Name: PAYLESS PHARMACY #21-336
  • Facility Address: 1500 W MCGALLIARD RD
    MUNCIE, IN
    ZIP 47304
  • Facility Phone: 765 741-1494
  • Facility Type: Other - PHARMACY
  • Facility Type: Waiver
  • Lab Director: KEITH OVERHOLT
  • NPI Number: 1255845871
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 15D2143485
LAB Type Other - PHARMACY
Facility Name PAYLESS PHARMACY #21-336
Street 1500 W MCGALLIARD RD
City MUNCIE
State IN
ZIP 47304
Phone 765 741-1494
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2024
Certificate Expiration Date 1/30/2026
Facility Type Other - PHARMACY
Lab Director KEITH OVERHOLT

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This page was last updated on: 9/29/2025